Staffing in radiation oncology practices has always been plagued with administrative issues. The process of radiation therapy consists of a series of steps and often involves a number of different individuals. Each practice should establish a staffing program consistent with patient care, administrative, research and other responsibilities. It is recognized that talent, training and work preferences may vary from individual to individual; therefore, it is appropriate to factor these aspects into a staffing program. Since the 1980’s many organizations have published benchmarks for radiation therapy staffing. Among these organizations are AAPM, ACR, ACRO, AAMD, ASRT and a few private market research institutions. These reports provide benchmarks for the staffing of not only medical physicists, but also dosimetrists, radiation therapists, and nurses. It is worth noting that some of these reports were generated before computer information system technology became a part of radiation treatment systems. We believe that development of benchmarks for staffing in radiation therapy practices is very important and directly affects the quality of patient care and safety. Until we finalize this study, here are some recent staffing levels in radiation therapy practices as published by the ACR for radiation oncology program accreditation. We will post more articles on this topic in a timely fashion and encourage our readers to send us their thoughts and comments on this issue.

http://www.acr.org/accreditation/radiation/requirements.aspx

Staffing in radiation oncology practices has always been plagued with administrative issues. The process of radiation therapy consists of a series of steps and often involves a number of different individuals. Each practice should establish a staffing program consistent with patient care, administrative, research and other responsibilities. It is recognized that talent, training and work preferences may vary from individual to individual; therefore, it is appropriate to factor these aspects into a staffing program. Since the 1980’s many organizations have published benchmarks for radiation therapy staffing. Among these organizations are AAPM, ACR, ACRO, AAMD, ASRT and a few private market research institutions. These reports provide benchmarks for the staffing of not only medical physicists, but also dosimetrists, radiation therapists, and nurses. It is worth noting that some of these reports were generated before computer information system technology became a part of radiation treatment systems. We believe that development of benchmarks for staffing in radiation therapy practices is very important and directly affects the quality of patient care and safety. Until we finalize this study, here are some recent staffing levels in radiation therapy practices as published by the ACR for the purpose of radiation oncology program accreditation.

According to the ACR, for accreditation purposes “the facility’s staffing levels for radiation oncologists, physicists, radiation therapists and dosimetrists are compared to the accredited facility averages and averages for the facility’s stratum as defined in the following table. The table allows facilities to identify personnel and equipment utilization issues. Staffing recommendations may be part of the final report; however, variations from these levels generally do not result in withholding of accreditation unless inadequate staffing levels result in non-compliance with ACR Practice Guidelines and Technical Standards and/or compromise patient safety.”

We will post more articles on this topic in a timely fashion and encourage our readers to send us their thoughts and comments on this issue.

If you graduate from a residency program that does not offer or use an HDR after-loader for patient treatments, what problems, if any, could you encounter at your first job? The answer is simple, if you are expected to treat patients with an HDR after-loader as part of your job responsibilities, you are not qualified to be listed as an Authorized User (AU) in the HDR material license, and hence you cannot independently treat patients with an HDR after-loader. That is, you are not legally able to fulfill this part of your job description. It’s a potentially embarrassing circumstance in addition to one that may inconvenience physician scheduling. Read more

Just a quick note to let you know the mdphysics job board for medical physics jobs is now functional and will be updated several times a week. The job board includes not only medical physicist jobs, but also health physics and dosimetry positions. Feel free to post jobs to the board using the link at the bottom of the job board page (the link is located below all the listings). Please pass along the link to anyone you know who is hiring medical physicists and would like to post their listing.

10CFR Part 35 requires that a physicist who needs to do HDR procedure be listed as an Authorized Medical Physicist (AMP) in the material license. The link below discusses the §35.51 Training for an Authorized Medical Physicist.

I found this link to be quite useful, and I refer to it many times, so I am putting it here for your reference. This is especially useful for and applicable to new physicists who need to do HDR or for the RSOs who need to amend the material license to include new physicists in the license. I am guessing that all the agreement states have adopted this regulation from the NRC (or something similar to it).

Further, if you are changing your job and are already listed as an AMP in the material license in your present job, it’s important to take a copy of the material license with you to your new job! Believe me, this will save you, the RSO, and the institution a lot of time and possibly spare all of you a headache.

As physicists, we most likely have at least two things in common: 1. We are extremely busy with technical and scientific issues every day, and 2. Most of us are salaried employees. Putting these two things together, it is probably fair to say that most of us do not have the time to find out how our salaries are determined and where they come from. My personal feeling is that knowing the source of our salaries–which basically boils down to how much our organizations receive for our services–would help us negotiate better when it comes to raises and benefits. If like me, you are a busy, but curious physicist–someone who always wanted to know the formula for CPT but did not have the time to find out–the article in the link below gives you an exact formula for how Medicare pays MDs. This analytical article is very informative, educational, and useful. While the formula in this article applies to physicians–not physicists–it makes sense that a similar document and formula exists for technical and physics charges. If someone knows a similar source for physics charges/fees, please share it with the rest of us. Here is the link to the article: http://www.acro.org/washington/RVU.pdf

Update as of August 8, 2009: The post-doctoral/residency openings listed below have all been filled. New openings will be posted as they become available on the mdphysics medical physics job board.

Recent post-doctorate positions open in medical physics:

Position 1
The Department of Radiation Physics at the M. D. Anderson Cancer Center in Orlando, Florida, is looking for a medical physics post-doctoral fellow. The successful fellow will work under the supervision of Dr. Katja Langen. The fellow is expected to work on a project that is designed to assess the dosimetric effect of intra-fraction motion. This project is funded by one of our industrial partners. It will be conducted in a clinical setting, using research platforms of commercial treatment planning systems. Ideally we hope to recruit a person with a medical physics degree or someone with closely related experience. The applicant is expected to assist on all levels of this project, including code development, data generation, and publication.

The Radiation Physics Department is equipped with 2 modern Varian accelerators, a Novalis unit, two TomoTherapy units, a HDR unit, and a Calypso system. It is staffed by 6 full time physicists, 1 physics associate, 2 medical phyics residence, and 2 post-doctoral fellows.

The M. D. Anderson Cancer Center Orlando is part of the Orlando Health system. We are located in downtown Orlando, Florida.

Position 2
The Department of Radiation Oncology, Division of Medical Physics is currently recruiting for a medical physics resident. We expect the chosen candidate to start in the summer of 2009. Preference will be given to candidates holding a graduate degree in medical physics, physics or related sciences.

We are outfitted with two in house multi slice CT simulators with 4D capabilities. The Division of Medical Physics maintains 6 Varian linear accelerators with IMRT and IGRT capabilities including a Novalis Tx machine and a TomoTherapy unit. Additional equipment includes two
Nucletron HDR units, and an in-house dedicated imaging center including a GE PET/CT unit and SPECT. The operating rooms at CTRC are used for LDR and HDR brachytherapy implants. We also have a very active total body photon and electron (TBI and TSE) irradiation program.

There are several active research programs in the areas of IMRT, IMRS, SBRT, Monte Carlo simulations, 4D treatment planning, IGRT and adaptive radiotherapy. The Division of Medical Physics is comprised of 5 faculty physicists, 5 dosimetrists, 13 doctoral students, three postdoc fellows, 5 dosimetry students, and a physics assistant.

The successful candidate will possess the ability to work well in a strong team environment, and contribute to our clinical programs. The residency program is structured based on the AAPM residency recommendations in therapy physics and we are currently seeking
accreditation from CAMPEP.

Position 3
The Department of Radiation Oncology, Physics Section, invites applications for a “Clinical Physics Associate” to begin on or before July 1, 2009. This is a clinical medical physics residency position and no prior clinical medical physics experience is required. This physics professional receives training and provides clinical medical physics service in radiation oncology under the supervision of qualified medical physicists. The Clinical Physics Associate is expected to: provide all treatment planning and quality assurance aspects for external beam radiotherapy and brachytherapy; perform acceptance testing, commissioning, and calibration of therapy equipment, computer systems, instruments, and devices; provide clear written documentation as required; participate in the selection and evaluation of new therapy equipment and systems; participate in the development of new treatment programs; participate in clinical and didactic instruction, all under the direction and guidance of faculty physicists. Minimum qualifications are a M.S. in medical physics or a Ph.D. in a related field. Strong preference is given to candidates having an advanced degree (M.S. or Ph.D.) in medical physics from a CAMPEP accredited program.

The Radiation Oncology Department is part of the Arizona Cancer Center a NCI designated Comprehensive Cancer Center. Five attending physicians and six medical residents see approximately 1200 new patient consults annually and provide treatments using three linear
accelerators (Novalis/Varian, Elekta SLi and TomoTherapy HiArt), HDR brachythearpy (Varian VariSource), LDR prostate seed implants, eye plaques, and cervical implants and other special procedures performed in our department including SRS, SBRT, and IGRT. The physics section
is comprised of four physics faculty and two medical physics residents (clinical physics associates). The University of Arizona is a major research university having excellent resources and abundant opportunities for collaborations and career growth, providing
exceptional benefits, and many educational, cultural, and recreational experiences. It is located in Tucson, Arizona in the heart of the Sonoran Desert.

Application must be made online at http://www.hr.arizona.edu (Job #42717).

Application review begins 04/24/2009 and continues until the open position is filled.